Breast Cancer Disparities Mostly Explained by Facility Factors
THURSDAY, Jan. 3, 2019 -- Delays in diagnosis and use of under-resourced health centers account for most racial and ethnic disparities in breast cancer diagnosis, according to a study published online Jan. 2 in Cancer Epidemiology, Biomarkers & Prevention.
Richard B. Warnecke, Ph.D., from the University of Illinois at Chicago, and colleagues assessed the role of neighborhood context, patient resources, facility characteristics, and mode of detection in determining the disparity in later stage at diagnosis of breast cancer among non-Hispanic black (NHBlack) and Hispanic patients versus non-Hispanic white (NHWhite) patients. Participants in the Breast Cancer Care in Chicago study (411 NHBlack, 397 NHWhite, and 181 Hispanic patients) were interviewed. Medical records were reviewed for information on screening and diagnostic follow-up.
After adjusting for neighborhood context, mode of detection, and facility accreditation/resources, the researchers found no significant disparity in later-stage breast cancer diagnosis between NHBlack or Hispanic patients versus NHWhite patients. NHBlack and Hispanic patients were more likely to be diagnosed at a disproportionate share facility versus NHWhite patients (37 and 47 percent, respectively, versus 11 percent). Further, NHBlack and Hispanic patients were more likely to experience a diagnostic delay in excess of 60 days compared with NHWhite patients (27 and 32 percent, respectively, versus 12 percent). Racial/ethnic differences in mode of detection and facility accreditation/resources accounted for most of the disparity in stage at diagnosis.
"Understanding the referral process and referral decisions made by primary care physicians could improve access to care among underserved women," Warnecke said in a statement.
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Posted: January 2019